男性尿道内尖锐湿疣的超声评价

目的评价尿道超声在男性尿道内尖锐湿疣的临床价值. 方法尿道超声技术检测临床怀疑尿道内尖锐湿疣的患者22例.采用患者自行排尿方法充盈尿道.经直肠超声径路检测后尿道,经会阴的腹侧以序纵向和横向显示球部尿道、阴囊部尿道和阴茎部尿道.对病理证实的尿道内尖锐湿疣进行超声分型.所有患者同时接受尿道镜检查.结果超声在17例患者中的前尿道中发现83个赘生物,病理证实是尖锐湿疣81例.声像图可以分为息肉型、乳头型和菜花型三种类型,分别占1.2%、38.3%和60.5%.超声对乳头型和菜花型赘生物的诊断特异性较高,对于息肉性的赘生物与结晶鉴别较难.所有患者的后尿道均未发现赘生物.结论尿道超声是诊断尿道内尖锐湿疣的敏感的影像学方法.可以提供病变的部位、范围以及是否合并尿道狭窄等信息,对于尿道内尖锐湿疣治疗后的随访是良好的诊断工具.

Ultrasonographic assessment of urethral condyloma acuminatum in men

OBJECTIVE: To evaluate the value of ultrasonography in diagnosing urethral condyloma acuminatum (CA) in men. METHODS: Twenty-two male patients, aged 36 +/- 19, diagnosed as with urethral CA based on history and clinical symptoms underwent ultrasonography and urethroscopy. The patients were asked to micturate to distend the urethra. The posterior urethra was detected by transrectum approach. Transperineal scans were performed to image the bulbar urethra, scrotal urethra and penile urethra. The sonographically positive results were compared with the pathological results. RESULTS: Eighty-three vegetations were found in the anterior urethra of seventeen patients, and eighty-one vegetations were diagnosed as CA by pathology, of which 1.2% were polyp shape, 38.3% papillary shape, and 60.5% cauliflower mass. Sonourethrography was an accurate predictor of papillary shape and cauliflower mass; however, it was difficult to differentiate between polyp shape vegetation and crystal. CONCLUSION: Sonourethrography is a sensitive and accurate tool not only for primary diagnosis of but also for follow-up of urethral CA in men.